Pubmed du 17/03/09

mercredi 18 mars 2009

1. Blaylock RL. A possible central mechanism in autism spectrum disorders, part 3 : the role of excitotoxin food additives and the synergistic effects of other environmental toxins. Altern Ther Health Med ;2009 (Mar-Apr) ;15(2):56-60.

There is compelling evidence from a multitude of studies of various design indicating that foodborne excitotoxin additives can elevate blood and brain glutamate to levels known to cause neurodegeneration and in the developing brain, abnormal connectivity. Excitotoxins are also secreted by microglial activation when they are in an activated state. Recent studies, discussed in part 1 of this article, indicate that chronic microglial activation is common in the autistic brain. The interaction between excitotoxins, free radicals, lipid peroxidation products, inflammatory cytokines, and disruption of neuronal calcium homeostasis can result in brain changes suggestive of the pathological findings in cases of autism spectrum disorders. In addition, a number of environmental neurotoxins, such as fluoride, lead, cadmium, and aluminum, can result in these pathological and biochemical changes.

2. Corbett BA, Constantine LJ, Hendren R, Rocke D, Ozonoff S. Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Res ;2009 (Mar 11)

Executive functioning (EF) is an overarching term that refers to neuropsychological processes that enable physical, cognitive, and emotional self-control. Deficits in EF are often present in neurodevelopmental disorders, but examinations of the specificity of EF deficits and direct comparisons across disorders are rare. The current study investigated EF in 7- to 12-year-old children with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and typical development using a comprehensive battery of measures assessing EF, including response inhibition, working memory, cognitive flexibility, planning, fluency and vigilance. The ADHD group exhibited deficits in vigilance, inhibition and working memory relative to the typical group ; however, they did not consistently demonstrate problems on the remaining EF measures. Children with ASD showed significant deficits in vigilance compared with the typical group, and significant differences in response inhibition, cognitive flexibility/switching, and working memory compared with both groups. These results lend support for previous findings that show children with autism demonstrate generalized and profound impairment in EF. In addition, the observed deficits in vigilance and inhibitory control suggest that a significant number of children with ASD present with cognitive profiles consistent with ADHD.

3. Ghanizadeh A. Autism : is it all in the head ? Altern Ther Health Med ;2009 (Mar-Apr) ;15(2):8 ; author reply 8.

4. Guttmann-Steinmetz S, Gadow KD, Devincent CJ. Oppositional Defiant and Conduct Disorder Behaviors in Boys With Autism Spectrum Disorder With and Without Attention-Deficit Hyperactivity Disorder Versus Several Comparison Samples. J Autism Dev Disord ;2009 (Mar 16)

We compared disruptive behaviors in boys with either autism spectrum disorder (ASD) plus ADHD (n = 74), chronic multiple tic disorder plus ADHD (n = 47), ADHD Only (n = 59), or ASD Only (n = 107). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 including parent- (n = 168) and teacher-rated (n = 173) community controls. Parents rated children in the three ADHD groups comparably for each symptom of oppositional defiant disorder (ODD) and conduct disorder. Teacher ratings indicated that the ASD + ADHD group evidenced a unique pattern of ODD symptom severity, differentiating them from the other ADHD groups, and from the ASD Only group. The clinical features of ASD appear to influence co-morbid, DSM-IV-defined ODD, with implications for nosology.

5. Lacroix A, Guidetti M, Roge B, Reilly J. Recognition of emotional and nonemotional facial expressions : A comparison between Williams syndrome and autism. Res Dev Disabil ;2009 (Mar 13)

The aim of our study was to compare two neurodevelopmental disorders (Williams syndrome and autism) in terms of the ability to recognize emotional and nonemotional facial expressions. The comparison of these two disorders is particularly relevant to the investigation of face processing and should contribute to a better understanding of social behaviour and social cognition. Twelve participants with WS (from 6 ;1 to 15 years) and twelve participants with autism (from 4 ;9 to 8 years) were matched on verbal mental age. Their performances were compared with those of twelve typically developing controls matched on verbal mental age (from 3 ;1 to 9 ;2). A set of five tasks assessing different dimensions of emotional and nonemotional facial recognition were administered. Results indicated that recognition of emotional facial expressions is more impaired in Williams syndrome than in autism. Our study comparing Williams syndrome and autism over a small age range highlighted two distinct profiles which call into question the relationships between social behaviour/cognition and emotion perception.

6. Rossignol DA, Rossignol LW, Smith S, Schneider C, Logerquist S, Usman A, Neubrander J, Madren EM, Hintz G, Grushkin B, Mumper EA. Hyperbaric treatment for children with autism : a multicenter, randomized, double-blind, controlled trial. BMC Pediatr ;2009 (Mar 13) ;9(1):21.

ABSTRACT : BACKGROUND : Several uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements ; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism. METHODS : 62 children with autism recruited from 6 centers, ages 2-7 years (mean 4.92+/-1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen ("treatment group", n=33) or slightly pressurized room air at 1.03 atm and 21% oxygen ("control group", n=29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC). RESULTS : After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p=0.0008), receptive language (p<0.0001), social interaction (p=0.0473), and eye contact (p=0.0102) ; 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved" compared to 2/26 (8%) of controls (p=0.0471) ; 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p=0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p=0.0336), receptive language (p=0.0168), and eye contact (p=0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p<0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p=0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p=0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated. CONCLUSIONS : Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air. Trial Registration : clinicaltrials.gov NCT00335790.


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